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Cardiomyopathy is a condition that weakens and enlarges your heart muscle, making it harder for your heart to pump blood and deliver it to the rest of your body. Cardiomyopathy treatment is important because the disease can lead to heart failure.
Cardiomyopathy Care at UVM Medical Center
As one of the leading heart programs in the region, cardiologists at the UVM Medical Center offer a broad range of diagnostic exams and treatments for cardiomyopathy and all types of cardiac problems. Patients have access to leading-edge technology and work with highly trained and experienced cardiologists who are on the frontiers of cardiac medicine.
There are three main types of cardiomyopathy:
Hypertrophic cardiomyopathy - This type happens when the heart muscle grows too thick, so the heart gets bigger and its chambers get smaller. The thickening heart muscle stiffens the heart, which makes it difficult for it to get enough blood and oxygen, and can cause chest pain. Hypertrophic cardiomyopathy can begin at any age, but the condition tends to be worse the earlier in life it starts. Hypertrophic cardiomyopathy runs in families and is the most common genetic heart disease.
Dilated cardiomyopathy - This is the most common type of cardiomyopathy, and often develops after a heart attack damages the heart muscle. Dilated cardiomyopathy is a condition where weak heart muscle starts to stretch (dilate). This reduces your heart's ability to pump blood and can result in heart failure. Although dilated cardiomyopathy can affect people of all ages, it happens most often in middle-aged people and is more likely to affect men. Some people have a family history of the condition.
Restrictive cardiomyopathy - The heart muscle in people with restrictive cardiomyopathy becomes stiff, meaning the heart can't stretch to allow enough blood to enter its lower chambers, the ventricles. So blood that would normally enter the heart backs up in your circulatory system, and this usually leads to heart failure. Restrictive cardiomyopathy can happen at any age, but it most often affects older people. The condition may be caused by diseases that affect the heart, or for no known reason (idiopathic). Restrictive cardiomyopathy is the least common type of cardiomyopathy.
You may not experience cardiomyopathy symptoms in the early stages of the condition, but as it advances cardiomyopathy symptoms are likely to appear. Regardless of the type of cardiomyopathy you have, symptoms tend to get worse without treatment. This process can happen quickly or slowly.
If your doctor suspects you may have cardiomyopathy, they may have a conversation with you about your symptoms and conduct a physical exam. You will be referred to a doctor specializing in heart problems (cardiologist) for further diagnostic tests. Our diagnostic tools include:
- Echocardiogram is a noninvasive test using ultrasound waves to evaluate your heart's structure and blood flow. A computer translates the ultrasound waves into an image of your heart. The image is displayed on a monitor, and it can be recorded on videotape or printed on paper.
- EKG or ECG (Electrocardiogram) is a painless test using patches with wires (called electrodes) attached to your chest to measure your heart's electrical impulses. The electrodes are hooked up to a machine that displays or prints your heart's electrical activity.
- Cardiac catheterization and biopsy is a procedure where a thin flexible tube (cardiac catheter) is inserted in your groin (femoral artery). Then the catheter is threaded through your blood vessels to your heart, where a small tissue sample (biopsy) is removed for later analysis in the laboratory. Also, this test can measure how forcefully blood pumps through the chambers of your heart and can take pictures of the heart's arteries (coronary angiogram) to see if you have any blockage
- Cardiac magnetic resonance imaging (MRI) is a diagnostic imaging technique that uses magnetic fields and radio waves to make images of your heart.
- Blood tests help your doctor determine the cause of your symptoms. For example, one blood test measures B-type natriuretic peptide (BNP), a protein made in your heart. The level of BNP rises in your blood when your heart undergoes stress from heart failure, a common cardiomyopathy complication.
- Chest X-ray is a picture of the chest that shows your heart, lungs, airway, blood vessels, and lymph nodes.
Treatments for Cardiomyopathy
The goals of cardiomyopathy treatment are to manage your symptoms, prevent your condition from worsening, and reduce your risk for complications. The treatment course your team of physicians recommends depends on the results of your diagnostic testing and which types of cardiomyopathy you have, among other factors. Cardiomyopathy treatment options at include:
Surgically Implanted Devices for Cardiomyopathy
Sometimes your heart needs some help from medical devices, including:
A pacemaker helps your heart beat at a regular rate.
- ICD(Implantable Cardioverter-Defibrillator)
An ICD is a special type of pacemaker that monitors your heart rate and gives electrical shocks when necessary.
- VAD (Ventricular Assist Device)
A VAD is also known as a heart pump and can be implanted in the chest or worn outside the body. It is a mechanical device that helps pump blood from the heart to the rest of your body. VAD used before a heart transplant can help people live until they receive the transplant.
Cardiac Catheterization for Cardiomyopathy
Cardiac catheterization is a procedure where a thin flexible tube (cardiac catheter) is inserted in your groin (femoral artery). Then the catheter is threaded through your blood vessels to your heart. Cardiac catheterization procedures avoid major surgery and a lengthy recovery.
- Alcohol Septal Ablation
When the area of the heart muscle that divides the right and left chambers (septum) becomes too thick, the lower left heart chamber (left ventricle) becomes blocked and it is unable to pump normally. The thickened septum is reduced in size by injecting alcohol through a catheter to destroy some of the heart muscle. This decreases the left ventricle's blockage and improves its pumping ability.
Surgery for Cardiomyopathy
Your cardiologist may recommend surgery if medicines do not help relieve severe symptoms of heart failure.
- Heart Transplant
Usually, a heart transplant is a last resort if you have severe cardiomyopathy and medications can't control your symptoms.
- Septal Myectomy
In this surgery, part of the overgrown heart muscle is removed. Usually, the extra muscle tissue is found in the septum, which divides the left and right lower heart chambers (ventricles). An overgrown septum can block the left ventricle's functioning and limit blood flow out of the heart. Most people who have this surgery recover well and end up with fewer symptoms. After surgery, physical activity is easier, too.
Medications may be prescribed alone or in combination with other cardiomyopathy treatments. Your doctor may prescribe one or more of the following:
- Angiotensin-Converting Enzyme (ACE) Inhibitors
These medicines reduce the formation of angiotensin, a substance that causes blood vessels to constrict, resulting in increased blood pressure. ACE inhibitors lower blood pressure and reduce strain on the heart.
- Angiotensin Receptor Blockers (ARBs)
These drugs block the action of angiotensin, preventing and limiting its negative impact on the blood vessels and the heart. They may be an alternative for patients who cannot tolerate ACE inhibitors.
- Beta Blockers
Beta blockers help decrease the demand on your heart, helping the heart muscle to relax, slowing your heart rate and lowering blood pressure.
- Digoxin (Lanoxin)
This drug, also known as digitalis, increases the force of your heart muscle's contractions, helping it beat more strongly.
Also known as water pills, these drugs help reduce fluid buildup in the body. They can lessen congestion in the lungs and reduce swelling in the abdomen, legs, and feet.
- Calcium Channel Blockers
Help stabilize your heart rate by reducing the number of electrical impulses that pass through parts of the heart.